Best Treatment for HBv

[jcm60]

I am 53 years old last month I have went for preventive health check up and based on the report findings the followings noted; SGOT 83 IU/L ,SGPT 200 IU/L , Doctor recmended me to see the Gastro.consultant , the gastro.consultant advised me to go for others test the result are as follows: Anti-dsDNA 16.6 IU/ml. , HBsAg test value 9520(Reactive) ,HCV,IgG test value 0.12 ( non Reactive) ,Anti Nuclear Antibody ( ANA) 0.12 , Immunoglobulin IgA 279 mg/dl , Tissue Transglutaminase antibody IgA 0.40 U/mL , Anti Mitochondrial Antibody , Serum 0.26 UL/ml , ASMA 2.70 U/mL , LKM Antibody 0.02 U/ml , Hepatitis B envelope Antibody test value (Ab) 43.0 ( Reactive) , Hapatitis Be Antigen ( HBeAg) 0.15 ( Non reactive),AFP 4.38ng/ml  , HBV DNA Quantitative,Real Time PCR 5156250 IU/ml. Based on this the Doctor advised me for the treatment  Tab.Entavir 0.5 mg one daily. Here i went for second opinion with Lever specialist consultant and he advised me to go for Fibroscan which the result is 5.91 Kpa ( Negative for fibrosis).Now the lever specialist advised for Viraferon Peg 80 mg once in a week and monitor CBC & S creatin every 15 days.I have not started the treatment yet as I am going out of India for 1.5 months as Doctor told me that this treatment will be given under there supervision , please suggest which treatment is suitable under these report.Also with vaccine this problem will be solved and how long i have to take this treatment.

[stef2011]

also keep in mind that you are still very vit d deficient in the tissues and cells because your pth is very high.so you are having no effect from the vit d you have in blood

the difficult thing is your calcium, was it 10.6 before starting vit d?maybe the 60.000iu dose once a week is making damage

i d reconsider hbsag levels, hbvdna when pth falls at least 20-30pg/ml

[stef2011]

i see nothing different as regards pth/vitd correlation from me, my sister and many other hbv carriers

the only thing you have more is damage from low vit d to kidneys and some imbalance.
the first thing to do is try everything to lower calcium, like high dose vit k2 mk4 (45mg daily) and vit k2 mk7 200mcg daily.there is no toxicity from these types of vit k

vit d, it is best to use daily vit d at 20.000iu or higher depending to response, stop big doses once a week.studies shown daily dose is beneficial, weekly doses unknown, monthly doses worsen.maybe high calcium is from these big doses which makes up and down levels of vit d

keep the no dairies and 2.5l low ca water

if you feel bone pains you are rebuilding bones from osteoporosis or weak bones, this will go away by time

[jcm60]

Hi Stef: I have done some test this week , followings are result.


HBV DNA Quantitative , Real time PCR : Plasma
- on 28 Jan.2014- 5156250 IU/mL.
- 1 May 2014:  - 33181 IU/mL.

- 9 August 2014: = 5.72x10^2 IU/ml.

- 8 Nov. 2014: 47.5 IU/ml.
- 20 Feb.2015 : 6.04 IU/mi.

HBsAg Quantitative:

- on 28 Jan. 2014:  : 7767.68 IU/mL.

- on - 1 May 2014:  6812.40 IU/m

- 9 August 2014: 3585 IU/ml.

8-  Nov.2014: 4633 IU/ml

- 20 Feb.2015 : 5174 IU/ml.



L.F.T.-

- 28 Jan.2014
SGOT / AST 48 U/L.
SGPT / ALT - 106 U/L.
ALK . Phosphatase - 139 U/L.

L.F.T.-
-  27/4/2014-
SGOT / AST 40 U/L.
SGPT / ALT  65 U/L.
Alkaline Phosphatase ( ALP ) 143 U/L.

L.F.T :
9 August 2014:

Serum billrubin total ( Jendrassik- Grof) 0.8 mg/dl ,
Serum Billrubin direct ( Jendrassik - Grof) 0.1 mg/dl,
Serum Billirubin Indirect 0.70 mg/dl ,
AST/SGOT ( kinetic-Henry) 10 IU/L  ,
ALT / SGPT ( kinetic-Henry) 26 IU/L ,
Serum Alkaline Phosphatase ( Kinetic) 110 IU/L ,
GGT 22 IU/L , S.total Protein ( Bluret) 7.3g/dl ,
S.Albumin 4.1 g/dL ,
S.Globulin 3.20g/dL ,
A\G Ratio 1.28.

L.F.T
- on 8 Nov.2014:
Serum Biluirubin indirect 0.50 mg/dl ,
AST/SGPT ( kinetic - Henry) 24 IU/L. ,
ALT/SGPT ( Kinetic Henry) 34 IU/L. ,
Serum Alkaline Phosphatase ( Kinetic) 136 * High  IU/L. ,
GGT 17 IU/L. ,
S.total protein 7.8 g/dl. ,
S.Albumin 4.1 g/dl. ,
S.Globulin 3.70*High g/dl ,
A\G Ratio 1.11* Low.

LFT: On 25Jan.2015:
SGOT/AST:  12.8IU/L ( Ref.range 0.0 -37.0)
SGPT/ALT : 24.7 IU/L ( Ref.range 0-41 )

LFT : On 20 Fe.2015:
ALT : 26 IU/L ( Ref.Range 10-40)
Serum Alkaline Phosphatase 112* High IU/L ( Ref.Range 32-92)
GGT : 21 IU/L ( Ref.Range 7- 64)


Blood Urea Method Serum :
-  8 Nov.2014 22.2 mg/dl.
- 25 Jan.2015 : Blood Urea : 21.2 mg/dl.
- 25 Jan.2015 : Blood Urea Nitrogen ( BUN) : 9.91 mg/dl


Creatinine Method Serum 1.06* High ( Normal Range 0.2 - 1)
Serum Creatinine on 25Jan.2015: 1.2 mg/dl ( Ref.Range 0.7 - 1.2)
Urea/Creatinine Ratio on 25Jan.2015 : 17.67 * LOW mg/dl ( Ref.Range 20-35)


Vitamin D,25 Hydroxy:
- on 8 Nov.2013 : Vitamin D , 25 - Hydroxy ,Serum ( CLIA ) 41.05 nmol/L.
- on 22 June 2014Vitd25oh :18.22 ng/ml.
- on 24/8/2014 : 51 ng/ml.
- on 8 Nov.2014 : 51.2 ng/ml.
- on 7 Feb.2015 : 157.55 nmol/L ( Sufficient range 75-250 nmol/L )

PTH ( Parathyroid Hormone) Intact, Serum :
- on 7 Feb.2015 : 73 pg/mL ( Ref.Interval 14 - 72 )

Kidney Function Test:
-on 5 Feb.2015:
Blood Urea: 21 mg% ( Normal Range 15-45)
Serum Creatinine 1.0mg% ( normal range 0.5 - 1.2 )
Serum Uric Acid : 5.7mg% ( normal range 3.4 - 7.0)
Calcium 10.5mg% ( normal range 8.2 - 10.3)
Phosphours 3.2mg% (normal range 2.5 -4.8)
Sodium 140mEq/L ( normal range 136-145)
Potassium 3.9 MEq/L ( normal range 3.5-5.1)

KFT on 20Feb.2015:
- Blood Urea : 21.8 mg/dl.
- Serum Creatinine : 1.02 * HIGH mg/dl.
- Rest of the test on KFT are normal range.

FibroScan:
On 26 Dec.2014 : 4.7.
On 9 August 2014 : 4.9.

My liver Doc.suggested me to meet with ENDOCRINOLOGIST as my PTH had increased as stated above. I met with this DOc. and he checked and suggested some blood test which are as follows:
On 23 Feb.2015:
- Albumin Serum 4.46g/dL ( Ref Range 3.50- 5.20)
- Alkaline Phosphatase ( ALP) Serum 153 U/L ( Ref.Range 30-120)
- Calcium Serum 10.60 mg/dl ( Ref.Range 8.80-10.60)
- Phosphorus Serum 2.00mg/dl ( 2.40- 4.40)

Looking into these test 2 test are beyond Ref.range like ALP & Phosphorus .

I have started K2 MK7 along with D3.
Doctor Endocrinologist thought that we need to correct the dose of D3, based on these report he will priscribe the d3 dose. but so far I am taking 10000IU daily & 60K once in week ,Sunday off.
This doctor also verify the Hormone produced in thyroid / PTH.He also asked me to repeat these test after 10 days. along with 25 hydro. & PTH.
As mentioned earlier i have pain in my upper back near to the shoulder joints.
Also my HbSag increased and HBV DNA had reduced.
Looking forward your opinion as always.
Thank you,

[jcm60]

Thank you so much Stef , I had Vitamin k earlier . I shall start it once again along with Vit d.

[stef2011]

you must eliminate all dairies, this is mandatory, they increase osteoporosis risk and add vitamin k mk7 to reduce calcium in blood and fix that into bones

i also had all those pains years ago and posted about it, all gone since vit d and low norm calcium in blood.the combo vit d plus vit k is mandatory for this

i have used this as vit k mk7 because most supplements are too low on this or if you like natto is full of vit k
https://www.bigvits.co.uk/product.asp?pid=953&cid=309&tid=&bid=

[jcm60]

Hi Stef
Thanks for your advise , Yes I agreed with you that it can create osteoporosis and I have little symptom of neck pain where Doctor suggested me some exercise for the neck.
Also I have continuously pain on my right side shoulder joint and it still some time shifting up & down.This is because of high PTH & serum calcium. Please suggest should I continue D3 dose 1000 IU daily and 60000 IU on Saturday. Sunday no D3 dose.Water I am taking more than 3 Ltrs. & 3-4 times green tea. Dairy product reduced.
Suggest how to lower the PTH value.
Hbsag & HBV DNA test will be conducted next month. shall share the report with you.
Thanks once again for your help.